3 Infection occurs when all six links in the chain are intact.Chain of InfectionCertain conditions must be met in order for a microbe or infectious disease to be spread from person to person.Infection occurs when all six links in the chain are intact.Source: OSHA

5 Infection Control What? Breaking the chain of infectionWhy? Prevent infections within health facilitiesHow? Consistent practice of protocols that prevent an infectious agent moving from one host to anotherWho? Protects:PatientsHCWsVisitorsOther staff

6 “If carefully implemented, Infection Prevention and Control measures will reduce or stop the spread of the [Ebola] virus and protect health-care workers (HCWs) and others.”-WHO 2014Interim Infection Prevention and Control Guidance for Care of Patients with Suspected or Confirmed Filovirus Haemorrhagic Fever in Health-Care Settings, with Focus on Ebola

7 So how strong is infection control at your facility?Infection Control can:Stop/reduce the spread of EbolaProtect Health care workersSo how strong is infection control at your facility?

8 Core Components for Infection Prevention & Control (IPC) ProgramsChecklist Organization of IPC program Technical guidelines Human resources (training, staffing, occupational health) Surveillance of diseases and monitoring of practices Microbiology laboratory support Clean and safe environment Monitoring and evaluation of IPC program Links with public health and other servicesSlide adapted and used with permission from World Health Organization

11 INFECTION CONTROL PREPAREDNESS CHECKLIST ADMINISTRATIVE GUIDANCEDone and completedOn goingNot StartedADMINISTRATIVE GUIDANCEReview and distribute the Guidelines for Environmental Infection Control in Health-Care Facilities.xReview laboratory procedures for appropriate specimen collection, transport, and testing of specimens from patients who are suspected to be infected with Ebola virus.Review policies and procedures for screening and work restrictions for exposed or ill healthcare personnel, and develop sick leave policies for healthcare personnel that are flexible and consistent with recommendations,Review protocols for sharps injuriesEnsure all HCP handling EVD patients proper medical clearance

12 INFECTION CONTROL PREPAREDNESS CHECKLISTDone and completedOn goingNot StartedTRAININGReview ICP training status of all personnel. All training requirements in PPE and infection control should be metxEducate and train HCP on the following areas:Management and exposure precautions for suspected or confirmed Ebola casesProper use of PPE (donning and doffing)Hand HygieneRespiratory fit testSick leave policiesSafe sharp practicesWaste ManagementReview environmental cleaning procedures and provide education/refresher training for cleaning staffConduct education and refresher training with healthcare personnel on Ebola for special pathogen handling in the laboratory.Review plans for special handling of linens, supplies, and equipmentProvide education/refresher training for healthcare personnel responsible for cleaning.

14 INFECTION CONTROL PREPAREDNESS CHECKLISTDone and completedOn goingNot StartedASSESSConduct spot checks and inspections of triage staff to determine if they are incorporating screening procedures and are able to initiate notification, isolation, and PPE procedures for your hospital.xSpot-check frequently to be sure standard, contact and droplet infection control and isolation guidelines are being followed, including safe putting on and removing PPE.

15 How will you strengthen your IPC?Administrative supportChecklists/AuditEbola coordinator:Appointed staff member to oversee adherence to the infection control measures in your facilityThe professional in charge of infection control in the facilityThe focal person to coordinate Ebola activities and advise-WHO 2014

16 Breaking the Chain of InfectionActivity/Discussion:In what ways can we break the chain of infection for Ebola in healthcare?

17 Breaking the Chain of InfectionReservoir: Patient infected with EbolaSignage and screening at entrances to healthcare settingsEarly identification of possible casesSeparation: Isolation or cohorting of possible casesCare and monitoring of people exposedMeans of Escape from the patient: Blood and body fluidsSafe handling of human remainsSymptomatic treatment of patients

20 When are Standard Precautions Needed?Basic essential component of infection controlApplied to every patient1st line of protection from Ebola transmission in health facilitiesEbola symptoms are non-specificApply to ALL patients

21 Standard Precautions IncludeHand hygieneGloves before anticipated contact with body fluids, mucous membrane, non-intact skin and contaminated itemsGown and Eye protection before procedures and patient-care activities likely to involve contact with or projection of blood or body fluids.Best practices for injection safetySafe handling and disposal of sharp instrumentsSafe cleaning and disinfection of the environmentCorrect re-processing of reusable equipmentAdequate laundry and waste managementWHO 2014

22 KEY PRINCIPLES FOR EBOLAPrior to working with Ebola patients, all healthcare workers involved in the care of Ebola patients must have received repeated training and have demonstrated competency in performing all Ebola-related infection control practices and procedures, and specifically in donning/doffing proper PPE.While working in PPE, healthcare workers caring for Ebola patients should have no skin exposed.The overall safe care of Ebola patients in a facility must be overseen by an onsite manager at all times, and each step of every PPE donning/doffing procedure must be supervised by a trained observer to ensure proper completion of established PPE protocols.

23 How well are standard Precautions per WHO standards currently implemented in your facility?

24 “Ebola is an unforgiving and a frightening disease“Ebola is an unforgiving and a frightening disease. But it can be defeated if we work together in solidarity and with effective coordination”UN Deputy Secretary General Jan Eliasson